Phantom Limb Pain

The Basics of Phantom Limb Pain

Phantom limb pain is severe pain felt in the area where a limb has been removed by amputation. These sensations usually decrease gradually and disappear over time. However, some patients continue to have phantom limb pain for the duration of their lives.

Although the body part is no longer there, the nerve endings continue to send pain signals to the brain, causing the perception of a limb that is still present. Sometimes, the brain retains a memory of pain, regardless of sensing signals from nerves.

Most patients who have a limb amputation experience phantom sensations. Also, approximately 75% of these patients experience phantom limb pain. Following the amputation, the phantom limb is perceived as the pre-amputation limb in regards to shape, volume, and length. The phantom sensations includes feelings of movement and posture, as well as hot and cold sensations.

Risk Factors for Phantom Limb Pain

Doctors do not know why some patients develop phantom limb pain after amputation while others do not. However, some factors increase the risk of this phenomenon:

Pain prior to the amputation – Patients who had pain before the limb removal are more likely to have it afterwards. Experts believe this is because the brain holds the memory of pain.

Stump pain – Patients who have stump pain after the amputation are more likely to develop phantom pain. The stump pain is related to an abnormal growth on damaged nerve endings.

Poor-fitting prosthesis – If the artificial limb does not fit properly, it can result in pain.

Symptoms associated with Phantom Limb Pain

The patient will often experience other symptoms along with the phantom limb pain. These symptoms include:

Tingling

Cramping

Sensations of heat and/or cold in the area where the limb was removed

Treatment Options

Transcutaneuos electrical nerve stimulation (TENS) – A device is worn on the body that sends weak electrical current via adhesive patches on the skin. This interrupts the pain signals, which prevents them from reaching the brain.

Spinal cord stimulation – The doctor surgically implants a small device near the spinal cord. The unit delivers electrical current via a wire, which interrupts pain signals.

Acupuncture – The doctor inserts extremely small sterilized needles into the skin, which stimulate the central nervous system to release endorphins (feel-good chemicals).

Injections – The doctor injects a long-acting anesthetic and a corticosteroid into the stump.